A person is socially withdrawn, speaks in odd ways, has strange ideas, and expresses little emotion, but is not displaying full-blown schizophrenic symptoms. What phase of schizophrenia is this person in?

A.

prodromal

B.

active

C.

residual

D.

either a or c

2.

Schizophrenics who wave their arms around in wild motions and make kicking motions with their legs are experiencing

A.

catatonic stupor.

B.

catatonic excitement.

C.

catatonic rigidity.

D.

catatonic posturing.

3.

The cognitive view of schizophrenia is based on the assumption that schizophrenics experience strange and unreal sensations

A.

and then tell their friends and family, who deny the reality of the sensations.

B.

and misinterpret them as "normal."

C.

that have no basis in biology.

D.

that are confirmed by their schizophrenic mothers.

4.

Alogia is a(n)

A.

example of inappropriate affect.

B.

positive symptom of schizophrenia.

C.

negative symptom of schizophrenia.

D.

psychomotor symptom of schizophrenia.

5.

A schizophrenic who is unable to recognize other people's needs and emotions and who doesn't know much about everyday events and issues is displaying

A.

poverty of speech.

B.

blunted or flat affect.

C.

loss of volition.

D.

social withdrawal.

6.

Which of the following is the best example of a double-bind communication?

A.

saying "Get away from me" while frowning and crossing one's arms

B.

saying "I love you" but refusing to allow the child in your lap

C.

saying "I love you" and cuddling the child

D.

saying "Get away from me. You are not my child when you act like that."

7.

Who of the following is displaying a symptom of type II schizophrenia?

A.

Edna walks around screaming about the pretty-colored insects that are bothering her.

B.

Fred is a happy guy who is convinced that he is Fred Astaire and must dance at every opportunity.

C.

Wes is certain that the IRS is out to get him and take his fortune. He is hiding out quietly in the hospital.

D.

Rosa sits in a chair in the corner, never smiling, never speaking, never interacting with either the staff or the other patients.

8.

David Rosenhan sent eight normal people to various psychiatric hospitals complaining of hearing voices that said "empty," "hollow," and "thud." All eight people acted normally after being admitted to the hospital, yet all were diagnosed as schizophrenic. One of the conclusions from this study is that

A.

clinicians are unable to detect "real" schizophrenia.

B.

the expectations produced by labeling can alter perception.

C.

hospitals can produce schizophrenic behavior in normal people.

D.

auditory hallucinations are sufficient for diagnosis as schizophrenic.

9.

Patients are more likely to recover from schizophrenia if they

A.

had hallucinations but no delusions.

B.

showed delusions but no hallucinations.

C.

demonstrated good premorbid functioning.

D.

had primarily negative rather than positive signs.

10.

A common symptom of paranoid schizophrenia is

A.

auditory hallucinations.

B.

psychomotor disturbance.

C.

affect that is cool and aloof.

D.

loose associations and neologisms.

11.

Patients with Type II schizophrenia are more likely than those with Type I schizophrenia to

A.

respond to traditional antipsychotic drugs.

B.

have enlarged ventricles.

C.

display positive symptoms of schizophrenia.

D.

have lesser cognitive disturbances.

12.

What percentage of the world population is estimated to have schizophrenia?

A.

0.05%

B.

1%

C.

5%

D.

10%

13.

Iphi glowered, and when her son did not come over to say hello, she said, "What's wrong? Don't you love your old mom anymore?" This is a(n)

A.

distorted message.

B.

existential message.

C.

narcissistic message.

D.

double-bind message.

14.

Benny has hallucinations, funny behavior, ridiculous leaps of logic, and is generally unable to function outside an institution. He is most likely to be helped by

A.

colzapine.

B.

a phenothiazine.

C.

an antidepressant.

D.

a sedative hypnotic.

15.

According to Freud, schizophrenic people

A.

regress to the anal period.

B.

are the victims of double-bind communication.

C.

regress to a pre-ego state of "primary narcissism."

D.

receive a label that influences them to behave in a schizophrenic manner.

16.

People around those who have been diagnosed as schizophrenic begin to treat them as if they are "crazy," expecting and overreacting to odd behaviors that they might not even notice in others. This observation is most consistent with the ___________ understanding of schizophrenia.

A.

psychodynamic

B.

family systems

C.

cognitive

D.

sociocultural

17.

Poverty of speech, blunted and flat affect, loss of volition, and social withdrawal are all examples of _________ symptoms of schizophrenia.

A.

positive

B.

negative

C.

hallucinatory

D.

psychomotor

18.

Freud thought that schizophrenia developed because inadequate parents caused their children to

A.

regress to a state of primary narcissism.

B.

develop unnecessarily harsh superego control.

C.

give up any attempts to reestablish ego control.

D.

become excessively concerned with the needs of others.

19.

What marital schism and marital skew have in common is that the children

A.

are rejected by both their parents.

B.

are encouraged to be overly dependent on the parents.

C.

are caught in the middle of marital conflict.

D.

are abused both physically and emotionally.

20.

Which of the following is a tactile hallucination?

A.

That dog is singing to me and asking me to sing along.

B.

That butterfly is growing so much it is as big as the house.

C.

There are invisible bugs crawling under my skin.

D.

My intestines are a mass of wiggling worms.

21.

What is the rate of concordance for schizophrenia in identical twins?

A.

2-5%

B.

15-18%

C.

40-60%

D.

70-80%

22.

A schizophrenic who tastes chlorine in untreated, natural water, and then thinks that his wife is trying to slowly poison him is experiencing a(n) ___________ hallucination and a delusion of _____________.

A.

auditory, grandeur

B.

tactile, control

C.

olfactory, reference

D.

gustatory, persecution

23.

A schizophrenic who said, "It's time for supper, supper, supper. Supper is on in the supper room," is experiencing

A.

loose associations.

B.

neologisms.

C.

perseveration.

D.

clang.

24.

A schizophrenic who is experiencing alogia is displaying

A.

poverty of speech.

B.

blunted or flat affect.

C.

loss of volition.

D.

social withdrawal.

25.

If the dopamine hypothesis provides an accurate explanation of the cause of schizophrenia, one would expect that a drug that was effective against Parkinson's disease symptoms might

A.

be an antipsychotic.

B.

have no effect on psychotic behavior.

C.

put the patient at risk for psychotic symptoms.

D.

decrease the amount of dopamine in certain areas of the brain.

26.

Which of the following best supports the dopamine hypothesis for schizophrenia?

A.

Like those with Parkinsonism, schizophrenics have unusually low levels of dopamine.

Researchers found that phenothiazines reduced psychotic symptoms but also caused Parkinsonian symptoms (e.g., tremors). This discovery suggests that

A.

schizophrenia masks Parkinson's disease.

B.

schizophrenia is tied to excessive dopamine.

C.

excessive dopamine is tied to Parkinson's disease.

D.

schizophrenia causes the synthesis of excessive amounts of dopamine.

28.

A decrease in the fluency and productivity of speech, seen in schizophrenia, is termed

A.

alogia.

B.

blocking.

C.

avolition.

D.

catatonia.

29.

Type II schizophrenia is associated with

A.

structural abnormalities in the brain.

B.

biochemical abnormalities in the brain.

C.

better prior adjustment and premorbid functioning.

D.

both structural and biochemical brain abnormalities.

30.

Occasionally, you see or hear things. Your friends tell you it's your imagination. Eventually you come to think your friends are hiding something and you develop delusions of persecution to explain their behavior. This thinking leads you down the "rational road to madness." This scenario is consistent with the __________ view.

A.

cognitive

B.

behavioral

C.

existential

D.

psychodynamic

31.

The term "schizophrenia" is derived from the Greek for

A.

split mind.

B.

frantic mind.

C.

multiple personality.

D.

hysterical demeanor.

32.

People with deficiencies in smooth-pursuit eye movement would be less able to

A.

focus on an object.

B.

track an object with their eyes.

C.

turn their heads from side to side.

D.

blink in response to strong light.

33.

Schizophrenics who remain motionless and silent for long periods of time are experiencing

A.

catatonic stupor.

B.

catatonic excitement.

C.

catatonic rigidity.

D.

catatonic posturing.

34.

A man who believes his thoughts are being influenced by the disk jockey on the radio is experiencing

A.

delusions of reference.

B.

delusions of persecution.

C.

delusions of grandeur.

D.

delusions of control.

35.

Martin is a schizophrenic person who feels ambivalent about most issues. He has no goals and does not seem to have the energy or interest to think about them. He certainly cannot make decisions. He is suffering from

A.

disturbances in affect.

B.

disturbances in volition.

C.

a disturbed sense of self.

D.

a disturbed relationship with the outside world.

36.

Olive is hospitalized. She spends most of her time frozen in place. When she is moved by a nurse or physician, she remains in the position she is put into. This is an example of _______ schizophrenia.

A.

catatonic

B.

paranoid

C.

disorganized

D.

undifferentiated

37.

Recently the dopamine hypothesis for schizophrenia has been challenged because it has been discovered that

A.

new effective drugs suggest abnormal neurotransmitter activity of serotonin as well as dopamine.

B.

excessive dopamine activity contributes to Type II and not Type I schizophrenia.

C.

atypical antipsychotic drugs work exclusively on dopamine receptors.

D.

Type I schizophrenics respond better to atypical than to traditional antipsychotic drugs.

38.

You have found enlarged ventricles during a postmortem analysis of a sample of brain tissue. This is most likely to be evidence of

A.

conversion disorder.

B.

Type I schizophrenia.

C.

Type II schizophrenia.

D.

schizophreniform disorder.

39.

Delia does not display all the full-blown schizophrenia symptoms any more. Occasionally, a shadow of a symptom appears. She is a bit withdrawn and not entirely clear all the time, but she can marginally function in the world. This is an example of _______ schizophrenia.

A.

residual

B.

catatonic

C.

paranoid

D.

undifferentiated

40.

A schizophrenic who is unusually silly, engages in odd mannerisms, and grimaces is most likely experiencing ___________ schizophrenia.

A.

disorganized

B.

catatonic

C.

paranoid

D.

undifferentiated

41.

Which of the following antipsychotic drugs appears to work at serotonin receptors?

A.

Haldol

B.

clozapine

C.

chlorpromazine

D.

the phenothiazines

42.

Which part of the brain is involved in Parkinson's disease?

A.

limbic system

B.

cerebral cortex

C.

substantia nigra

D.

the reticular activating system

43.

The schizophrenic symptom most likely to be relieved by antipsychotic drugs is

A.

delusions.

B.

flat affect.

C.

lack of speech.

D.

lack of purpose.

44.

Most patients who lived on the back wards of state mental hospitals in the mid-1900s

A.

were schizophrenics.

B.

were given individual "talk" therapy to no avail.

C.

interacted well with each other but not with staff members.

D.

all of the above.

45.

Maxwell Jones created an approach to psychotherapy of the institutionalized in London called

A.

oral therapy.

B.

group therapy.

C.

a token economy.

D.

the therapeutic community.

46.

The side effect of antipsychotic drugs, known as akathisia, is marked by

A.

delusions.

B.

shouting obscenities.

C.

restlessness and agitation.

D.

bizarre movements of the tongue and neck.

47.

If you went to a meeting of a group lobbying for better care for the mentally ill and made up primarily of family members of people with severe mental disorders, you would probably be attending

A.

the National Alliance for the Mentally Ill.

B.

the Association for Retarded Citizens.

C.

the Society for Social Workers and Case Managers.

D.

the Halfway House Paraprofessional Affiliates.

48.

A person who is experiencing a potentially fatal reaction to an antipsychotic drug involving muscle rigidity and autonomic nervous system dysfunction is displaying

A.

Parkinson-like symptoms.

B.

neuroleptic malignant syndrome.

C.

tardive dyskinesia.

D.

akathisia.

49.

If a patient's chart said the patient had extrapyramidal side effects, you would expect to see the patient showing primarily _______ dysfunction.

A.

motor

B.

cognitive

C.

emotional

D.

language

50.

Karen has been taking chlorpromazine for 25 years. Lately, she has been quite restless and agitated. She complains of soreness in her joints and fatigue from moving all the time. Her condition would probably be diagnosed as

A.

dystonia.

B.

akathisia.

C.

tardive dyskinesia.

D.

neuroleptic malignant syndrome.

51.

Schizophrenics who also have substance abuse disorders are assigned a case worker who makes sure they know about and can use whatever is available to support them. They are receiving

A.

coordinated services.

B.

partial hospitalization.

C.

halfway house services.

D.

occupational training.

52.

Who was the first physician to develop the prefrontal lobotomy for use on human patients?

A.

Egas Moniz

B.

Eliot Valenstein

C.

Walter Freeman

D.

Carlyle Jacobsen

53.

What is a primary technique that insight therapists use to treat schizophrenia?

A.

challenging patients' statements

B.

altering the psychotic person's behavior

C.

using medication to reduce thought disturbances

D.

encouraging specific life adjustments by providing community support services

54.

What is the focus of social therapy in treating schizophrenia?

A.

placing the patient in a halfway house

B.

finding work and housing for the patient

C.

finding a community mental health center for the patient

D.

helping the patient interact more effectively in the family environment

55.

What is the best example of a token in everyday life?

A.

food

B.

money

C.

power

D.

shelter

56.

The proportion of patients taking antipsychotic medication who eventually develop tardive dyskinesia is about

A.

1%.

B.

10%.

C.

20%.

D.

50%.

57.

Which (humanistic) therapy is based on the premise that when you change the social environment, you change the patient?

A.

milieu therapy

B.

insight therapy

C.

family therapy

D.

the token economy

58.

The chief contribution of Philippe Pinel to the care of those with severe mental illnesses was to

A.

develop state hospitals for those who couldn't afford private care.

B.

use antipsychotic drugs in highly controlled settings.

C.

treat patients with sympathy and kindness.

D.

all of the above.

59.

The technique for treating mental patients that was pioneered by Egas Moniz was

A.

ECS therapy.

B.

the lobotomy.

C.

the use of drugs.

D.

the cingulotomy.

60.

How do the new antipsychotic drugs differ from traditional ones?

A.

They work at serotonin as well as dopamine sites.

B.

They cause fewer extrapyramidal effects.

C.

They are especially effective for Type II schizophrenics.

D.

All of the above.

61.

What proportion of homeless persons are estimated to suffer from severe mental disorders?

A.

most

B.

about half

C.

about a third

D.

about a quarter

62.

In the past, the most common pattern of deterioration in patients that apparently resulted from institutionalization was

A.

movement disorder.

B.

paranoid delusions.

C.

auditory hallucinations.

D.

social breakdown syndrome.

63.

Schizophrenics who attend all-day programs that include supervised activities and therapy to improve social skills are receiving

A.

coordinated services.

B.

partial hospitalization.

C.

halfway house services.

D.

occupational training.

64.

Why is psychotherapy unsuccessful in treating schizophrenia?

A.

Schizophrenia increases the strength of most ego defense mechanisms.

B.

Insurance does not cover psychotherapy for patients diagnosed as schizophrenic.

C.

Unmedicated schizophrenics are too far removed from reality to form the relationship needed.

D.

Excessive dopamine interferes with the process of free association that is requisite to the success of psychotherapy.

65.

Parkinson-like symptoms in one taking antipsychotic medication

A.

mean that one must stop taking the medication.

B.

can usually be successfully treated with an anti-Parkinsonian drug.

C.

unfortunately cannot be successfully treated at this time.

D.

lead to neuroleptic malignant syndrome.

66.

Donna has been treated with chlorpromazine for several years. Lately she seems to be chewing gum all the time, and her arms are always in motion. She has begun to display twitches and she has a facial tic. This is an example of

A.

dystonia.

B.

akathisia.

C.

tardive dyskinesia.

D.

neuroleptic malignant syndrome.

67.

Which of the following drugs can cause a dangerous drop in the number of white blood cells in the body?

A.

clozapine

B.

Thorazine

C.

haloperidol

D.

chlorpromazine

68.

The usual way of dealing with troublesome or violent schizophrenic people in institutions in the first half of the twentieth century was to

A.

use drugs.

B.

beat them.

C.

ignore them.

D.

use physical restraint.

69.

Which therapist would be most likely to say, "Stay in your own private world as long as you need to, until you want to come out and share the world with me?"

A.

Minuchin

B.

Fromm-Reichmann

C.

Baucom

D.

Dixon

70.

The largest "mental institution" in the United States (meaning the place where the greatest number of people are treated for mental disorders each day) is

A.

the Manhattan shelter for homeless men.

B.

the Chicago public hospital.

C.

the Los Angeles county jail.

D.

the Boston Commons.

71.

Long-term mental patients frequently developed anger, aggressiveness, and loss of interest in personal appearance. This condition has been called

A.

psychosis.

B.

schizophrenia.

C.

social breakdown syndrome.

D.

neuroleptic malignant syndrome.

72.

Helen was just discharged from a public mental health facility. She went to live with a group of other former patients in a group-living arrangement. There were staff members to help out, but the former patients controlled most of the day-to-day activities. Helen's living arrangement is a

A.

day center.

B.

halfway house.

C.

short-term hospital.

D.

sheltered workshop.

73.

The first of the important group of antipsychotic drugs, the phenothiazines, was developed during the

A.

1940s.

B.

1950s.

C.

1960s.

D.

1970s.

74.

Very low dopamine activity is related to

A.

anxiety disorders.

B.

addictive behavior.

C.

Parkinson's disease.

D.

schizophrenic disorders.

75.

One of the unwanted side effects of antipsychotic medications is

A.

paralysis.

B.

hyperactivity.

C.

tardive dyskinesia.

D.

Parkinson's disease.

76.

What is the concern over the quality of the changes produced by token economies?

A.

Many studies of token economies are methodologically flawed.

B.

Some patients can function in normal life but deteriorate in the hospital.

C.

The skills learned in the hospital may not generalize to the outside world.

D.

The person may have learned new behaviors without changing his or her distorted thinking.

77.

Tory lives at home but spends his day at a mental health facility. The facility might be described as providing

A.

aftercare.

B.

coordinated services.

C.

partial hospitalization.

D.

short-term hospitalization.

78.

"Most schizophrenics were institutionalized in public hospitals and received only the basic necessities of life. Mostly patients were ignored, but sometimes abused." These statements are most characteristic of treatment in the United States in the year

A.

1750.

B.

1845.

C.

1930

D.

1990

79.

Which of the following is least likely to be a reason why there is such a shortage of services for people with schizophrenia?

A.

Health professionals prefer to work with people who are less seriously ill.

B.

Neighbors often object to having schizophrenics near them in the community.

C.

It is very costly to treat schizophrenics.

D.

There are no laws regarding the treatment rights of schizophrenics.

80.

A family with a high level of expressed emotion would display a great deal of

A.

concern.

B.

criticism.

C.

joyfulness.

D.

underinvolvement.

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